emergency departments

Objective: Few studies have investigated U.S. emergency department (ED) moped-related injuries. Our objective was to determine the characteristics of moped crashes among adult riders and to identify associations between key variables.Methods: Data were obtained from the National Electronic Injury Surveillance System (NEISS) for 2002-2014. Descriptive and comparative analyses of the identified cases were performed.Results: Based on a probability sample of 2,453 cases, an estimated 108,229 U.S. adult moped-related ED visits occurred during the study period. Injuries increased 2.7-fold over time. Summer months and weekdays were the most common crash times. Three-fourths of injured riders were male, two-thirds were ages 23-59 years, and 77% were Caucasian. Among cases documented, one-half were helmeted, and almost two-thirds of crashes occurred at ≤20 mph. The predominant mechanism was a non-collision crash (60%). Skin-related and musculoskeletal diagnoses were most common. Almost one-fifth of patients were admitted or transferred. Regression analyses showed that males were less likely than females to be in crashes with multiple riders, and more likely to have used alcohol/drugs and to be in a crash with another motor vehicle (MVC). Older riders (≥40 years) were more likely than those younger to have used alcohol/drugs and to suffer torso injuries, and less likely to be in an MVC. As compared to other crash mechanisms, MVCs were more likely to involve injuries to the head/neck/face and torso. The likelihood of being admitted/transferred was higher for males, with increasing age, and for collision-related crashes. The higher likelihood of being admitted/transferred was also characterized by alcohol/drug use, by lower limb and torso injuries, and almost 8 times more likely for riders with serious head injuries.Conclusions: Moped injuries increased in all adult age groups during the study period. However, there were significant differences in contributing factors, crash mechanism, and outcomes by sex, race, and age. These findings suggest the need for targeted injury prevention interventions.

A Comparison of Skeletal Injuries Arising from Moped and Motorcycle Collisions

Motorcycle and moped injuries remain a significant cause of motor-vehicle related morbidity and mortality. There is a paucity of literature describing the skeletal injuries of moped riders and how these compare to those of motorcyclists, however. This study seeks to examine the skeletal injuries sustained in such incidents and determine if there are significant differences. Hospitalized riders injured on powered two-wheeled vehicles (PTW) between 2004 and 2007 were entered into a registry along with their presentation and clinical course. This registry was sorted by PTW type. Riders with injuries of the appendicular skeleton, bony pelvis, and spine were extracted. Injuries were categorized by bone location. Demographic data, helmet use, head injury, facial fracture, Injury Severity Score (ISS), and mortality were extracted. Overall, 406/578 motorcyclists, 197/357 moped riders, and 62/92 dirt-bike riders sustained fractures of the appendicular skeleton, pelvis and/or spine. Motorcyclists had a significantly higher ISS upon presentation and had increased first-hospital day mortality in addition to more skeletal injuries, more fractures of the upper extremity, and more fractures of the spine, pelvis, and foot. Moped riders had a significantly lower rate of helmet use and higher rate of head injuries and facial fractures. In summary, while both moped and motorcycle riders share a risk for injuries of the lower extremity, their overall pattern of injury differs. Motorcyclists appear to be at increased risk for more severe injuries and injuries of the upper extremity, spine, and pelvis, while moped riders are at increased risk for significant head and facial injury.

Powered two-wheeler riders' risk of crashes associated with filtering on urban roads

OBJECTIVE

The objective of this study is to estimate the crash risk per kilometer traveled by powered two-wheeler (PTW) riders filtering through traffic on urban roads.

METHODS

Using the traffic injury crashes recorded by the police over a period of 3 years on 14 sections of urban roads in the city of Marseille, France, and a campaign of observations of PTWs, the crash risk per kilometer traveled by PTWs filtering was estimated and compared to the risk of PTWs that did not filter.

RESULTS

The results show that the risk of PTW riders being involved in injury crashes while filtering is significantly higher than the risk for riders who do not filter. For the 14 sections studied, it is 3.94 times greater (95% confidence interval [CI], 2.63, 5.89). This excess risk occurred for all PTW categories. Furthermore, no space appears to be safer than the others for filtering. Riders filtering forward along the axis of the carriageway, along bus lanes, or between traffic lanes (lane-splitting) all have a crash risk greater than the risk of those who do not filter.

CONCLUSIONS

All measures limiting the practice of filtering by PTWs on urban roads would probably contribute to improving the safety of their users.

Comparison of Injury Severity Between Moped and Motorcycle Crashes: A Finnish Two-Year Prospective Hospital-Based Study

BACKGROUND AND AIMS

The coverage of the official statistics is poor in motorcycle and moped accidents. The aim of this study was to analyze the severity of motorcycle and moped crashes, and to define the degree of under-reporting in official statistics.

MATERIAL AND METHODS

All first attendances due to an acute motorcyclist or moped driver injury registered in the emergency department between June 2004 and May 2006 were analyzed. The severity of the injuries was classified using the Abbreviated Injury Scale score and the New Injury Severity Score. The hospital injury data were compared to the traffic accident statistics reported by the police and compiled and maintained by Statistics Finland.

RESULTS

A total of 49 motorcyclists and 61 moped drivers were involved in crashes, leading to a total of 94 and 109 injuries, respectively. There were slightly more vertebral and midfoot fractures among motorcyclists than among moped drivers (p = 0.038 and 0.016, respectively). No significant differences were found between the severity (maximum Abbreviated Injury Scale and median New Injury Severity Scores) of the motorcycle and moped crashes. There was no in-hospital mortality. The degree of agreement (overlap) between the hospital dataset and the official statistics was 32%. The rate of under-reporting was 68%.

CONCLUSIONS

According to the maximum Abbreviated Injury Scale and New Injury Severity Scores, the injury severity was equal for motorcycle and moped crashes. The degree of agreement between the hospital dataset and the official statistics was 32%.